Background: Vitamin D enhances host protective immune responses to Mycobacterium tuberculosis by suppressing\r\nInterferon-gamma (IFN-g) and reducing disease associated inflammation in the host. The objectives of this study\r\nwere to determine whether vitamin D supplementation to patients with tuberculosis (TB) could influence recovery.\r\nMethods: Two hundred and fifty nine patients with pulmonary TB were randomized to receive either 600,000 IU of\r\nIntramuscular vitamin D3 or placebo for 2 doses. Assessments were performed at 4, 8 and 12 weeks. Early secreted\r\nand T cell activated 6 kDa (ESAT6) and Mycobacterium tuberculosis sonicate (MTBs) antigen induced whole blood\r\nstimulated IFN-g responses were measured at 0 and 12 weeks. Statistical comparisons between outcome variables\r\nat 0 and 12 weeks were performed using Studentââ?¬â?¢s t-test and Chi2 tests.\r\nResults: After 12 weeks, the vitamin D supplemented arm demonstrated significantly greater mean weight gain\r\n(kg) + 3.75, (3.16 ââ?¬â?? 4.34) versus + 2.61 (95% CI 1.99 ââ?¬â?? 3.23) p 0.009 and lesser residual disease by chest radiograph;\r\nnumber of zones involved 1.35 v/s 1.82 p 0.004 (95% CI 0.15, 0.79) and 50% or greater reduction in cavity size 106\r\n(89.8%) v/s 111 (94.8%), p 0.035. Vitamin D supplementation led to significant increase in MTBs-induced IFN-g\r\nsecretion in patients with baseline ââ?¬Ë?Deficientââ?¬â?¢ 25-hydroxyvitamin D serum levels (p 0.021).\r\nConclusions: Supplementation with high doses of vitamin D accelerated clinical, radiographic improvement in all\r\nTB patients and increased host immune activation in patients with baseline ââ?¬Ë?Deficientââ?¬â?¢ serum vitamin D levels. These\r\nresults suggest a therapeutic role for vitamin D in the treatment of TB.
Loading....